Library

Huangdi asked: How do pathogenic factors invade the human body? Is there a regularity in their high and low positions? Qibo replied: For the upper half of the body, they are invaded by wind pathogens; for the lower half of the body, they are invaded by dampness pathogens. If invading the Yin aspect, they remain in the Fu organs (hollow organs); if invading the Yang aspect, they remain in the Zang organs (solid organs). Huangdi said: Yin and Yang have different names but are of the same category; they meet above and below, and the meridians interconnect like a circle without beginning or end. When pathogens invade the body, they may invade the Yin or the Yang, with no fixed pattern in the upper, lower, left, or right. Huangdi said: The convergence points of all Yang meridians are located on the face. When a person is in a state of deficiency, or has just exerted themselves physically, or after drinking hot liquids and sweating, when the Cou Li (skin pores) are open, they are susceptible to pathogens. If the pathogen strikes the head, it descends into the Foot-Yangming Stomach Meridian; if it strikes the face, it descends into the Foot-Taiyang Bladder Meridian; if it strikes the cheek, it descends into the Foot-Shaoyang Gallbladder Meridian; if it strikes the chest, back, or flanks, it also enters the corresponding meridians. Pathogens invading the Yin aspect usually start from the arms. This is because the skin on the inner sides of the arms and legs is thin, and the muscles are soft and moist, so they are jointly susceptible to wind pathogens and uniquely injured in their Yin aspects. Huangdi asked: Does this necessarily injure the Zang organs? Qibo said: Invasion by wind pathogens does not necessarily disturb the Zang organs. Therefore, when pathogens enter the Yin meridians, if the Qi of the Zang organs is substantial, the pathogens cannot reside there and thus return to the Fu organs. Hence, invasion of the Yang aspect remains in the meridians, while invasion of the Yin aspect remains in the Fu organs. Huangdi asked: What is the situation when pathogens strike the Zang organs? Qibo said: Fear and worry injure the Heart; cold exposure of the body and consumption of cold drinks injure the Lungs, because the two types of cold interact, injuring both inside and outside, causing Qi to rebel and move upward. Falls or injuries causing blood stasis to remain internally, or extreme anger causing Qi to rush upward and fail to descend, accumulating under the flanks, will injure the Liver. Blows or falls, or sexual intercourse while drunk, sweating and then exposing oneself to wind, will injure the Spleen. Straining to lift heavy objects, or excessive sexual intercourse followed by bathing in cold water while sweating, will injure the Kidneys.

Huangdi asked: How do the Five Zang organs contract wind pathogens? Qibo said: When Yin and Yang Qi mutually resonate, pathogens can travel. The Twelve Primary Meridians and the 365 Luo Connecting Points, their Blood and Qi all ascend to the face and flow through the sensory orifices. The clear Yang Qi ascends to the eyes to form vision; branch Qi ascends to the ears to form hearing; the Zong Qi (Pectoral Qi) ascends out of the nose to form smell; the turbid Qi descends out of the Stomach to reach the lips and tongue to form taste. The fluids and essence of these Qi all steam upwards onto the face. Since the facial skin is thick and the muscles firm, even intense heat cannot be overcome by cold. When Xu Xie (deficiency pathogens) invade the body, they cause shivering and bodily trembling. Zheng Xie (regular pathogens) invading the body are subtle; they first manifest in the complexion, are not felt by the body, seem to exist and yet not, having form and yet formless, and no one knows their true nature. The complexion, pulse, and skin of the Cubital Region (Chi area) correspond to each other, like the drumstick and drum sound, or shadow and object, and must not lose this correspondence. This is also an external manifestation of the root and branches; if the root dies, the branches wither. Thus, a green complexion corresponds to a Wiry (Xian) pulse; a red complexion corresponds to a Hook (Gou) pulse; a yellow complexion corresponds to a Intermitting (Dai) pulse; a white complexion corresponds to a Hairy (Mao) pulse; a black complexion corresponds to a Stone (Shi) pulse. If the complexion is seen but the corresponding pulse is not found, and instead a controlling (overcoming) pulse is obtained, death will occur; if a generating pulse is obtained, the disease will heal. Huangdi asked: What are the manifestations of diseases generated by changes in the Five Zang organs? Qibo said: First determine the correspondence between the Five Complexions and Five Pulses, then the diseases can be distinguished. Huangdi asked: Once the complexion and pulse are determined, how else can they be differentiated? Qibo said: By examining the pulse for slackness/tightness, large/small, slippery/rough, the manifestations of the disease can be determined. Huangdi asked: How to examine them? Qibo said: If the pulse is tight, the skin of the Cubital Region is also tight; if the pulse is slack, the skin of the Cubital Region is also slack; if the pulse is small, the skin of the Cubital Region is diminished and indicates deficient Qi; if the pulse is large, the skin of the Cubital Region is also large; if the pulse is deep, the skin of the Cubital Region is also deep; if the pulse is slippery, the skin of the Cubital Region is also slippery; if the pulse is rough, the skin of the Cubital Region is also rough. All these variations have degrees of mildness and severity. Therefore, one skilled in examining the Cubital Region need not wait for the Cun Kou (radial) pulse; one skilled in examining the pulse need not wait for the complexion. One who can integrate all three methods can be called a Superior Physician, achieving nine cures out of ten; one who uses two methods is a Medium Physician, achieving seven cures out of ten; one who uses only one method is an Inferior Physician, achieving six cures out of ten. Warm and smooth/moist skin of the Cubital Region indicates Wind Disease. Weak flesh in the Cubital Region indicates Flaccidity Disease. Quiet lying down with muscle wasting indicates Cold-Heat Disease (another version says Incurable). Rough skin of the Cubital Region indicates Wind Bi Syndrome. Skin of the Cubital Region coarse like dried fish scales indicates Water Retention Disease. Very cold skin of the Cubital Region with a tight (or small) pulse indicates Diarrhea and Deficient Qi. Very hot skin of the Cubital Region with a full and restless pulse indicates Warm Disease. A full and slippery pulse indicates impending sweating (or disease onset). Burning-hot skin of the Cubital Region (like a torch), starting hot then becoming cold, indicates Cold-Heat Disease. Skin of the Cubital Region initially cold, becoming hot after prolonged pressure, also indicates Cold-Heat Disease. Burning-hot skin of the Cubital Region with a large Ren Ying (Carotid) pulse indicates Blood Loss. Hard skin of the Cubital Region with a very small pulse indicates Deficient Qi; if accompanied by specific ominous pulses, death occurs immediately (The Mai Jing states: A Chi pulse tighter than the Ren Ying pulse indicates Deficient Qi). Heat isolated at the elbow indicates heat in the upper waist. Heat isolated at the posterior elbow indicates heat in the shoulder and back. Heat isolated at the anterior elbow indicates heat in the anterior chest. Heat in the lower third of the posterior elbow indicates intestinal worms. Heat isolated at the hand indicates heat in the upper waist (or lower waist). Heat isolated in the middle of the arm indicates heat in the waist and abdomen. Heat in the palm indicates heat in the abdomen. Cold in the palm indicates cold in the abdomen. Blue blood vessels visible on the white flesh of the Thenar Eminence indicate Cold in the Stomach.

Huangdi asked: There is a case where the Cubital Region skin is extremely lax (or the Chi pulse is extremely rapid), and tendons are tense and visible. What disease is this? Qibo said: This is called Hu Jin (Fox Tendon Disease/Hernia). In Hu Jin Disease, the abdomen is necessarily tense; if the complexion shows white or black, the condition worsens.